Skip to main content

Advertisement

SpringerLink
Log in

Inconsistent mammography perceptions and practices among women at risk of breast cancer following a pediatric malignancy: a report from the Childhood Cancer Survivor Study

  • Original paper
  • Published:
Cancer Causes & Control Aims and scope Submit manuscript

Abstract

Women treated with chest radiation for a pediatric cancer have low mammography screening rates despite their high risk for breast cancer. This study characterized the relationship between perceptions of mammography and screening practices. A cross-sectional survey was administered to 523 women in North America who were treated with chest radiation before 21 years of age. Women with inconsistent mammography perceptions and practices were identified using the Pros and Cons of Mammography for perceptions and Transtheoretical Model stages of adoption for prior and intended screening practices. Classification and regression tree (CART) analysis was used to identify barriers to and facilitators of screening among women with positive and negative perceptions. Nearly one-third of the cohort had inconsistent perceptions and practices: 37.4% had positive perceptions and were not having mammograms; 27.6% had negative/neutral perceptions and were having mammograms. Regardless of perceptions, a recent physician’s recommendation for mammography, age ≥ 40, and interest in routine health care were universally associated with mammography practices. For women with positive perceptions and a physician’s recommendation, barriers to screening included high acceptance coping, low active-planning coping, and high internal health locus of control. For women with negative perceptions, acknowledging the importance of asymptomatic screening was associated with mammography.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Bhatia S, Yasui Y, Robison LL et al (2003) High risk of subsequent neoplasms continues with extended follow-up of childhood Hodgkin’s disease: report from the late effects study group. J Clin Oncol 21(23):4386–4394

    Article  PubMed  Google Scholar 

  2. Constine LS, Tarbell N, Hudson MM et al (2008) Subsequent malignancies in children treated for Hodgkin’s disease: associations with gender and radiation dose. Int J Radiat Oncol Biol Phys 72(1):24–33

    PubMed  Google Scholar 

  3. Guibout C, Adjadj E, Rubino C et al (2005) Malignant breast tumors after radiotherapy for a first cancer during childhood. J Clin Oncol 23(1):197–204

    Article  PubMed  Google Scholar 

  4. Kenney LB, Yasui Y, Inskip PD et al (2004) Breast cancer after childhood cancer: a report from the Childhood Cancer Survivor Study. Ann Intern Med 141(8):590–597

    PubMed  Google Scholar 

  5. Metayer C, Lynch CF, Clarke EA et al (2000) Second cancers among long-term survivors of Hodgkin’s disease diagnosed in childhood and adolescence. J Clin Oncol 18(12):2435–2443

    CAS  PubMed  Google Scholar 

  6. Taylor AJ, Winter DL, Stiller CA, Murphy M, Hawkins MM (2007) Risk of breast cancer in female survivors of childhood Hodgkin’s disease in Britain: a population-based study. Inter J Cancer 120(2):384–391

    Article  CAS  Google Scholar 

  7. Wolden SL, Lamborn KR, Cleary SF, Tate DJ, Donaldson SS (1998) Second cancers following pediatric Hodgkin’s disease. J Clin Oncol 16(2):536–544

    CAS  PubMed  Google Scholar 

  8. Landier W, Bhatia S, Eshelman DA et al (2004) Development of risk-based guidelines for pediatric cancer survivors: the Children’s Oncology Group long-term follow-up guidelines from the Children’s Oncology Group late effects committee and nursing discipline. J Clin Oncol 22(24):4979–4990

    Article  PubMed  Google Scholar 

  9. Long-Term Follow-Up Guidelines for Survivors of Childhood, Adolescent, and Young Adult Cancers (2007) Children’s Oncology Group. [Online]. Updated October 2008 [cited 2009 April 17]; Available from: www.survivorshipguidelines.org

  10. Oeffinger KC, Ford JS, Moskowitz CS et al (2009) Breast cancer surveillance practices among women previously treated with chest radiation for a childhood cancer. JAMA 301(4):404–414

    Article  CAS  PubMed  Google Scholar 

  11. Sohl SJ, Moyer A (2007) Tailored interventions to promote mammography screening: a meta-analytic review. Prev Med 45(4):252–261

    Article  PubMed  Google Scholar 

  12. Spencer L, Pagell F, Adams T (2005) Applying the transtheoretical model to cancer screening behavior. Am J Health Behav 29(1):36–56

    PubMed  Google Scholar 

  13. Rakowski W, Andersen MR, Stoddard AM et al (1997) Confirmatory analysis of opinions regarding the pros and cons of mammography. Health Psychol 16(5):433–441

    Article  CAS  PubMed  Google Scholar 

  14. Rakowski W, Dube CA, Goldstein MG (1996) Considerations for extending the transtheoretical model of behavior change to screening mammography. Health Educ Res 11(1):77–96

    Article  Google Scholar 

  15. Rakowski W, Fulton JP, Feldman JP (1993) Women’s decision making about mammography: a replication of the relationship between stages of adoption and decisional balance. Health Psychol 12(3):209–214

    Article  CAS  PubMed  Google Scholar 

  16. Clark MA, Rakowski W, Ehrich B et al (1998) Stages of adopting regular screening mammography: do women differ in decisional balance within stages? J Health Psychol 3(4):491–506

    Article  Google Scholar 

  17. Velicer WF, Hughes SL, Fava JL, Prochaska JO, DiClemente CC (1995) An empirical typology of subjects within stage of change. Addict Behav 20(3):299–320

    Article  CAS  PubMed  Google Scholar 

  18. Lemon SC, Roy J, Clark MA, Friedmann PD, Rakowski W (2003) Classification and regression tree analysis in public health: methodological review and comparison with logistic regression. Ann Behav Med 26(3):172–181

    Article  PubMed  Google Scholar 

  19. Breiman L, Friedman J, Olshen R, Stone C (1984) Classification and regression trees. Wadsworth, Pacific Grove

    Google Scholar 

  20. Cook EF, Goldman L (1984) Empiric comparison of multivariate analytic techniques: advantages and disadvantages of recursive partitioning analysis. J Chron Dis 37(9/10):721–731

    Article  CAS  PubMed  Google Scholar 

  21. Calvocoressi L, Kasl SV, Lee CH, Stolar M, Claus EB, Jones BA (2004) A prospective study of perceived susceptibility to breast cancer and nonadherence to mammography screening guidelines in African American and White women ages 40–79 years. Cancer Epidemiol Biomarkers Prev 13(12):2096–2105

    PubMed  Google Scholar 

  22. Robison LL, Mertens AC, Boice JD et al (2002) Study design and cohort characteristics of the Childhood Cancer Survivor Study: a multi-institutional collaborative project. Med Pediatr Oncol 38(4):229–239

    Article  PubMed  Google Scholar 

  23. Leisenring WM, Mertens AC, Armstrong GT et al (2009) Pediatric cancer survivorship research: experience of the Childhood Cancer Survivor Study. J Clin Oncol 27(14):2319–2327

    Article  PubMed  Google Scholar 

  24. Robison LL, Armstrong GT, Boice JD et al (2009) The Childhood Cancer Survivor Study: a National Cancer Institute-supported resource for outcome and intervention research. J Clin Oncol 27(14):2308–2318

    Article  PubMed  Google Scholar 

  25. Rakowski W, Clark MA, Pearlman DN et al. (1997) Integrating pros and cons for mammography and Pap testing: extending the construct of decisional balance to two behaviors. Prev Med 26(5 Pt 1):664–673

    Google Scholar 

  26. Rakowski W, Dube CA, Marcus BH, Prochaska JO, Velicer WF, Abrams DB (1992) Assessing elements of women’s decisions about mammography. Health Psychol 11(2):111–118

    Article  CAS  PubMed  Google Scholar 

  27. Carver CS, Scheier MF, Weintraub JK (1989) Assessing coping strategies: a theoretically based approach. J Pers Soc Psychol 56(2):267–283

    Article  CAS  PubMed  Google Scholar 

  28. Pui CH, Pei D, Sandlund JT et al (2005) Risk of adverse events after completion of therapy for childhood acute lymphoblastic leukemia. J Clin Oncol 23(31):7936–7941

    Article  PubMed  Google Scholar 

  29. Baker KS, Ness KK, Steinberger J et al (2007) Diabetes, hypertension, and cardiovascular events in survivors of hematopoietic cell transplantation: a report from the bone marrow transplantation survivor study. Blood 109(4):1765–1772

    Article  CAS  PubMed  Google Scholar 

  30. Wallston KA (2005) The validity of the multidimensional health locus of control scales. J Health Psychol 10(5):623–631

    Article  PubMed  Google Scholar 

  31. Steinberg D, Colla P (1997) CART—classification and regression trees. Salford Systems, San Diego

    Google Scholar 

  32. Steinberg D, Golovnya M (2006) CART 6.0 user’s manual. Salford Systems, San Diego

    Google Scholar 

  33. Breiman L (1996) Technical note: some properties of splitting criteria. Machine Learning 24:41–47

    Google Scholar 

  34. Harrell FE Jr (2001) Regression modeling strategies. Springer, New York

    Google Scholar 

  35. Rimer BK, Keintz MK, Kessler HB, Engstrom PF, Rosan JR (1989) Why women resist screening mammography: patient-related barriers. Radiology 172(1):243–246

    CAS  PubMed  Google Scholar 

  36. Yabroff KR, Mandelblatt JS (1999) Interventions targeted toward patients to increase mammography use. Cancer Epidemiol Biomarkers Prev 8(9):749–757

    CAS  PubMed  Google Scholar 

  37. Glenn BL, Moore LA (1990) Relationship of self-concept, health locus of control, and perceived cancer treatment options to the practice of breast self-examination. Cancer Nurs 13(6):361–365

    Article  CAS  PubMed  Google Scholar 

  38. Holm CJ, Frank DI, Curtin J (1999) Health beliefs, health locus of control, and women’s mammography behavior. Cancer Nurs 22(2):149–156

    Article  CAS  PubMed  Google Scholar 

  39. Magai C, Consedine N, Neugut AI, Hershman DL (2007) Common psychosocial factors underlying breast cancer screening and breast cancer treatment adherence: a conceptual review and synthesis. J Womens Health 16(1):11–23

    Article  Google Scholar 

  40. Murray M, McMillan C (1993) Health beliefs, locus of control, emotional control and women’s cancer screening behaviour. Br J Clin Psychol 32(Pt 1):87–100

    PubMed  Google Scholar 

  41. Masters K, Wallston K (2005) Canonical correlation reveals important relations between health locus of control, coping, affect and values. J Health Psychol 10(5):719–731

    Article  PubMed  Google Scholar 

  42. Wallston K (1991) The importance of placing measures of health locus of control beliefs in a theoretical context. Health Educ Res 6(2):251–252

    Article  Google Scholar 

  43. Wallston K (1992) Hocus-pocus, the focus isn’t strictly on locus: Rotter’s Social Learning Theory modified for health. Cognit Ther Res 16(2):183–199

    Article  Google Scholar 

  44. Di Gallo A, Amsler F, Gwerder C, Burgin D (2003) The years after: a concept of the psychological integration of childhood cancer. Support Care Cancer 11(10):666–673

    Article  PubMed  Google Scholar 

  45. Greenberg HS, Kazak AE, Meadows AT (1989) Psychologic functioning in 8- to 16-year-old cancer survivors and their parents. J Pediatr 114(3):488–493

    Article  CAS  PubMed  Google Scholar 

  46. Hill JM, Kornblith AB, Jones D et al (1998) A comparative study of the long term psychosocial functioning of childhood acute lymphoblastic leukemia survivors treated by intrathecal methotrexate with or without cranial radiation. Cancer 82(1):208–218

    Article  CAS  PubMed  Google Scholar 

  47. Olson AL, Boyle WE, Evans MW, Zug LA (1993) Overall function in rural childhood cancer survivors. The role of social competence and emotional health. Clin Pediatr (Phila) 32(6):334–342

    Google Scholar 

  48. Jamison R, Lewis S, Burish T (1986) Psychological impact of cancer on adolescents: self-image, locus of control, perception of illness and knowledge of cancer. J Chron Dis 39(8):609–617

    Article  CAS  PubMed  Google Scholar 

  49. Schwartz MD, Taylor KL, Willard KS, Siegel JE, Lamdan RM, Moran K (1999) Distress, personality, and mammography utilization among women with a family history of breast cancer. Health Psychol 18(4):327–332

    Article  CAS  PubMed  Google Scholar 

  50. Schwartz MD, Taylor KL, Willard KS (2003) Prospective association between distress and mammography utilization among women with a family history of breast cancer. J Behav Med 26(2):105–117

    Article  PubMed  Google Scholar 

  51. Williams-Piehota P, Schneider TR, Pizarro J, Mowad L, Salovey P (2004) Matching health messages to health locus of control beliefs for promoting mammography utilization. Psychol Health 19(4):407–423

    Article  Google Scholar 

  52. Castellino SM, Casillas J, Hudson MM et al (2005) Minority adult survivors of childhood cancer: a comparison of long-term outcomes, health care utilization and health related behaviors. J Clin Oncol 23(27):6499–6507

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by Grant R21-CA-106972 (K. C. Oeffinger, Principal Investigator) from the National Cancer Institute/Department of Health and Human Services and the Centers for Disease Control and Prevention, Grant U24-CA-55727 (L. L. Robison, Principal Investigator) from the Department of Health and Human Services, funding to the University of Minnesota from the Children’s Cancer Research Fund and funding to St. Jude Children’s Research Hospital from the American Lebanese Syrian Associated Charities (ALSAC).

Author information

Authors and Affiliations

  1. Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA

    Stephanie M. Smith

  2. Departments of Psychiatry & Behavioral Sciences and Pediatrics, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA

    Jennifer S. Ford

  3. Department of Community Health, Brown University, Box G-S121, Providence, RI, 02912, USA

    William Rakowski

  4. Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA

    Chaya S. Moskowitz

  5. Dana-Farber Cancer Institute/Childrens Hospital Boston, 44 Binney Street, Boston, MA, 02115, USA

    Lisa Diller

  6. St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Memphis, TN, 38105, USA

    Melissa M. Hudson & Leslie L. Robison

  7. Emory University, 201 Dowman Drive, Atlanta, GA, 30322, USA

    Ann C. Mertens

  8. University of California, 405 Hilgard Ave, Los Angeles, CA, 90095, USA

    Annette L. Stanton

  9. University of Chicago, 5801 South Ellis Avenue, Chicago, IL, 60637, USA

    Tara O. Henderson

  10. Fred Hutchinson Cancer Research Center, 1100 Fairview Ave. N., PO Box 19024, Seattle, WA, 98109, USA

    Wendy M. Leisenring

  11. Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA, 94305, USA

    Stephanie M. Smith

  12. Departments of Pediatrics and Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY, 10021, USA

    Kevin C. Oeffinger

Authors
  1. Stephanie M. Smith
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jennifer S. Ford
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. William Rakowski
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Chaya S. Moskowitz
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Lisa Diller
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Melissa M. Hudson
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ann C. Mertens
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Annette L. Stanton
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Tara O. Henderson
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Wendy M. Leisenring
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Leslie L. Robison
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Kevin C. Oeffinger
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kevin C. Oeffinger.

Appendices

Appendix A. Childhood Cancer Survivor Study (CCSS) institutions and investigators

The Childhood Cancer Survivor Study (CCSS) is a collaborative, multi-institutional project, funded as a resource by the National Cancer Institute, of individuals who survived 5 or more years after diagnosis of childhood cancer. CCSS is a retrospectively ascertained cohort of 20,346 childhood cancer survivors diagnosed before age 21 between 1970 and 1986 and approximately 4,000 siblings of survivors, who serve as a control group. The cohort was assembled through the efforts of 26 participating clinical research centers in the United States and Canada. The study is currently funded by a U24 resource grant (NCI grant # U24 CA55727) awarded to St. Jude Children’s Research Hospital. Currently, we are in the process of expanding the cohort to include an additional 14,000 childhood cancer survivors diagnosed before age 21 between 1987 and 1999. For information on how to access and utilize the CCSS resource, visit www.stjude.org/ccss. See Table 3.

Table 3 CCSS institutions and investigators
Full size table

Appendix B

See Table 4.

Table 4 Pros and cons of mammography
Full size table

Appendix C

See Table 5.

Table 5 Transtheoretical model stages of adoption
Full size table

Rights and permissions

Reprints and permissions

About this article

Cite this article

Smith, S.M., Ford, J.S., Rakowski, W. et al. Inconsistent mammography perceptions and practices among women at risk of breast cancer following a pediatric malignancy: a report from the Childhood Cancer Survivor Study. Cancer Causes Control 21, 1585–1595 (2010). https://doi.org/10.1007/s10552-010-9587-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10552-010-9587-5

Keywords

Search

Navigation